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Vestibular schwannomas (VS) commonly are limited to the internal auditory canal (IAC) and cerebellopontine angle. Extension to labyrinth is less frequent, and involvement of the middle ear or external acoustic canal (EAC) is very rare. In this report we present the case of a 41-year-old woman with a VS, which recurred after a previous surgical removal 4 years before. The tumor involved the IAC, cochlea, vestibule, semicircular canals, cavum tympani, mastoid cells, and EAC. Total removal of the tumor was achieved by a transotic approach, without neurological sequela.